Change GP contract for long-term care planning, says report

Primary care services which fail to support a new model of care planning for patients with long-term conditions should be 'decommissioned' and GP contracts realigned, a report co-written by the DH director of strategy warns.

Anna Dixon: former King's Fund expert now at DH

The report published by the influential King’s Fund think tank, calls on commissioners to adopt a ‘house of care’ model of ‘holistic, coordinated, person-centred’ with primary care as the cornerstone.

It calls for personalised care planning with clinicians and patients working together through shared decision-making. A ‘wide variety of organisations’ should work together with pooled budgets and shared data, to build the recommended model.

The report, by King's Fund visiting fellow Angela Coulter and Anna Dixon, former King's Fund director of policy and now director of strategy and quality and chief analyst at the DH, calls on NHS England to ensure the ‘GP contract is aligned to support this approach and that its incentives reflect the importance of care planning’. NHS England must also ‘be ready to decommission poor-quality primary care services’, the report says.

CCGs, it adds, should ‘help primary care shift from the current episodic approach to caring for patients with long-term conditions to an approach that is more anticipatory and planned’.

Health secretary Jeremy Hunt has set out plans to improve care for four major groups over four years, beginning with frail elderly people in 2014, those with long-term conditions in 2015, and then mothers with young children and finally those who are generally healthy.

The King’s Fund said it had been working closely with NHS England’s director for enhancing the quality of life for people with long-term conditions, Dr Martin McShane.

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